Who doesn’t like having a clean room, clean clothes and clean body parts? Who does not want to be sure that everything they need is in place? Who does not want to know for sure that their loved ones are safe from all kinds of harm? I guess, almost everyone. The problem however arises when the need for cleanliness, checking to ensure that you have everything as you need or that all your loved ones are safe exceeds a certain level, where it not only becomes distressing for the person and the near and dear ones, but also tends to cause significant disturbance with day to day functioning.
When cleaning, checking, counting, etc becomes uncontrolled, it is probably time to seek consultation with a Clinical Psychologist to rule out the presence of Obsessive Compulsive Disorder (OCD).
Obsessive Compulsive Disorder is an anxiety disorder with two main component - Obsessions and Compulsions. Obsessions are repetitive thoughts, images, urges or doubts that keep surfacing in the mind regarding simple things like contamination to severe things like hurting someone. Compulsions on the other hand are repetitive actions or behaviours that one feels compelled to perform in order to deal with the distress caused by the obsessions.
The following diagram may adequately explain the relation between obsessions and compulsions:
For someone suffering from OCD, the obsessions and compulsions are likely to cause a significant amount of distress and fear and also eat into a lot of their time, which they otherwise could have used in pursuing daily life activities. Yet another feature of OCD is Avoidance, that is, the person tends to avoid the objects, places, situations or experiences that aggravate their obsessions and corresponding compulsions. For example, a person with the obsession of contamination may always fear being infected by certain germs or viruses. Consequently, thee person may adopt compulsive behaviours like repeatedly washing their hands, clothes and even repeatedly cleaning their rooms. Consequently, the avoidance behaviour for this person would be avoid places or situations that are dirty, for example, the public toilets, or, in extreme cases, may even avoid leaving their homes altogether.
OCD is generally caused by a combined effect of dysfunctional thoughts, personal experiences and biolgical factors. Hencee, along with regular psychotherapy sessions by a trained Clinical Psychologist, OCD often requires medications to be prescribed by psychiatrists and, in most extreme cases, may require hospitalisation for a few days to a few weeks, depending upon the severity of the symptoms being manifested.
For a Clinical Psychologist, one of the most common method of treating OCD is through Cognitive Behaviour Therapy (CBT). CBT aims to identify connections between your thoughts, feelings and behaviour. It aims to help you develop practical skills to manage any negative patterns of thinking or behaviour that may be causing you difficulties. It can be done one-to-one, or in a group. There is considerable evidence to suggest that this therapy is especially effective in dealing with OCD.
The behavioural element (also known as Exposure Response Prevention – ERP) is strongly recommended for treating OCD. ERP works by helping you to confront your obsessions and resist the urge to carry out compulsions. The aim is to help you feel less anxious about obsessive thoughts over time, and make you less likely to engage in compulsive behaviour. For example, if you fear that you will harm someone and avoid sharp objects as a result, you might build up to a therapy session where you hold a knife while sitting in a room with other people.
This technique needs to be carefully managed to avoid causing distress and anxiety, so it is important that you understand the treatment fully and feel comfortable with your therapist.
Relaxation and mindfulness techniques are also used in the treatment of OCD. While learning a relaxation technique won’t help you resolve obsessive thoughts or compulsions, but it may help you deal with anxiety that you experience as a result of your OCD. Relaxation techniques can teach you:
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